I had my mitral valve replaced on the 8th of November and I am on warfarin for the rest of my life.
A part from week 2 after surgery, my INR is never been in the desired range.
At the beginning maybe because I was taking antibiotics due to a chest infection, but now is over a month i am not taking anymore antibiotics and it is still not in range. It should be beteween 2.5 and 3.5 but sometimes goes even below 2 and the highest it ha been is 2.2
I know that with some ppl it rates time, but mine seems going lower when I take a bigger dose of warfarin
At the moment I am taking 11mg daily.
Has anyone in this forum experienced anything similar?
I also heard about a different type of warfarin called Sintrom.dit anyone tried it?
Thank you in advance for your help
Rossnba
Written by
Rosanna75
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Who doses your warfarin? Your GP or the anticoagulation clinic? It's still very soon to be thinking you will be stabilised, but I'd encourage you to speak to your anticoagulation clinic if you are worried.
Hi, not to depress you but after my AVR it took 18 months to get my levels stable, mainly dropping to 1.5 from time to time but it will not kill you honestly, l know its a worry. l then had a breakthrough by eating loads of fresh sprouts and spinach which hired my INR everytime with the help of warfarin. Hope this helps. Sue.
Wow, it took 18 months for you, that's a very long time.
In regards of what you said about eating sprouts and spinach, I was under the impression that food very high in vitamin k would work against warfarin and would make your blood cloth.
Hi I was on warfarin for couple months in 2011 after stenting, found it a bit of a rigmarole being tested, then my cardiologist said I was too young for warfarin (51) Recently had quad bypass and didn't want to go down warfarin route again, so I insisted on alternatives, and I now take pradaxa (dabigatran) twice daily, with no ill effects and testing.
I too am on life long warfarin, it took a good eight months for my INR to settle down. It was nearly settled when I then saw my cardiac surgeon and he changed, lowered my target INR and we had to start again. Very frustrating.
At my GP practice, you phone in with your result to the practice manager who matches your result with an algorithm they work with. If there are any queries they speak to the GP. In the beginning of this journey I was having tests twice a week but recently I have been able to go ten weeks between testing.
It sounds like you are doing a good job diet wise. I am not vegetarian but do eat loads if veg. I still eat green veg but am careful with portion sizes. Alcohol is another thing to watch .
Hopefully as your general recovery and activity improves your INR will start to settle too but it does take time. There lots of comments on this forum about this subject which you may find helpful. You will also read about self testing, I now do this with the support of the practice and it really works for me but does not suit all.
You mention Sinthrom. I know it well. it is also called acenocoumarol and is very popular in countries such as France. Forget it. This form of anticoagulant has a shorter half-life and it is much more difficult to take to be stable.
There is a relationship between the two, so that a really skilled doctor can switch you between the two. This is well documented. Roughly, 2mg sinthrom = 4mg warfarin. There are problems with tablet size, which affects those taking low doses. Warfarin conveniently comes in sizes as low as 0.5mg. Conveniently, because for some people, a dose change of 0.25mg is enough to make a difference between in-range or out-of-range. In Britain, sinthrom only exists in 1mg sizes.
A half-life is one of the technical words used to describe how quickly a chemical stays in your system. it is not the only factor considered when dosing. In addition, with drugs, there are often several half-lives involved.
To simplify. When there is a long half-life, then day to day changes are slower, more sluggish. When there is a short half-life, you have to keep topping up more often. Some patients on sinthrom have to take it twice a day in order to stay stable. Warfarin patients take it once a day.
Doctors in Britain are highly unlikely to switch you to sinthrom.
Hi Rossanna. I had 2 valves replaced (Mitral and Iortic) with mechanical ones in 2002. The op was done in France where I live. I have been on 20g of "Previscan" (which is a similar med to Warfarin). My INR range is 3-4.5 INR, which is constantly fluctuating, even though my diet is kept pretty much the same. Although I have noticed that during summer months, I need to up the dose probably because on tends to eat more salads based meals.
As you are a vegetarian I would imagine that your basic daily dose should be higher than the 12mg that you state. Previscan like Warfarin is a fairly slow acting anti-coagulant, therefore it does take some days for the dose change to come into effect.
I have now settled on a fortnightly blood test (undertaken by our village nurses practice).
I also occasionally do my own "self test", using the "Coagucheck" machine which I bought privately, (luckily, the test refills are now paid for by the Social Security in France).
This has made an enormous difference to my peace of mind.
Speak again to your Anti-coagulant specialist explaining that you are a vegetarian.
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